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Jennifer Rollin MSW, LCSW-C

Eating Disorders

Weight-Bias Within The Eating Disorder Recovery Movement

How you can combat fat-phobia in the eating disorder recovery community.

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Source: Flickr

Our weight and diet-obsessed world is a complicated climate for individuals who are in eating disorder recovery. However, even within the eating disorder recovery community, fat-phobia and weight-stigma abounds. Weight stigma is commonly defined as shame, biases, or judgment, which is placed upon an individual based on their body size or weight. 

Currently, our culture places a large value on “thinness.” We are constantly sold the message that “thin” is good and “fat” is bad. 

Many fat activists are trying to reclaim the word "fat" as a neural descriptor - in the same way that we utilize words such as "tall" vs. "short." The problem is that in our culture the descriptor of "fat" has become synonymous with undesirable traits, such as being lazy, unattractive, and unhealthy.

Weight-bias within the eating disorder recovery community can have negative implications for individuals who are trying to recover. The following are three ways that fat-phobia is being perpetuated within the eating disorder recovery movement, and tips to combat these negative messages.

1. Eating disorder treatment professionals who perpetuate weight-stigma.

Unfortunately some eating disorder treatment professionals may unintentionally be promoting fat-phobic messages and weight-discrimination. In fact, one research study, which sought to examine this found that,

“Negative weight stereotypes were present among some professionals treating eating disorders. The majority had observed other professionals in their field making negative comments about obese patients, 42% believed that practitioners who treat eating disorders often have negative stereotypes about obese patients, and 29% reported that their colleagues have negative attitudes toward obese patients.” 

If you are a professional who treats clients with eating disorders, it is important that you are mindful of your own biases and judgments towards individuals on the basis of their body size and weight. For instance, repeatedly assuring your client that they are not “fat” is one way that you might be unwittingly perpetuating weight stigma. Rather than appearing highly alarmed by an individual’s declaration that they are fat, you could say something that is helpful and does not perpetuate weight-stigma.

For instance, if your client is struggling with anorexia nervosa and states that they feel incredibly “fat” you could say, “It sounds like your eating disorder voice is really loud today. What do you think might be triggering this?” This statement helps to externalize the client’s eating disorder voice from their healthy voice, which can be helpful for those who are struggling. Additionally, rather than focusing on their distorted thinking surrounding their weight, this statement shifts the focus to what else might be upsetting and triggering them to feel negatively towards their body.

If your client has a body type that is outside of the thin ideal standard and states that they feel “so fat and ugly,” you could start to educate them on body-positivity and body-diversity. Further, you could say something like, “I think that you are truly beautiful. People can be beautiful at any size,” and then explore with them the deeper issues that may be contributing to their body-hatred.

Unfortunately some eating disorder treatment professionals still promote weight loss and the idea that an individual’s weight is somehow indicative of their health. I would encourage both professionals who treat eating disorders, as well as those in recovery to familiarize themselves with the Health at Every Size movement. You can be “thin” and healthy and you can be “thin” and unhealthy. You can be “fat” and unhealthy and you can be “fat” and healthy. A person’s weight is simply not a good barometer of their health.

According to an article in The Nutrition Journal by Dr. Linda Bacon and Lucy Aphramor: "Most epidemiological studies find that people who are overweight or moderately obese live at least as long as normal weight people, and often longer."

Further, numerous studies have found that "obesity is associated with longer survival in many diseases. For example, “obese persons with Type 2 diabetes, hypertension, cardiovascular disease, and chronic kidney disease, all have greater longevity than thinner people with these conditions."

To learn more about this important movement, I would recommend checking out the book Health at Every Size by Dr. Linda Bacon and joining the Health at Every Size Facebook Group. As treatment professionals, it is critical that we work to promote the message that you can truly be beautiful and healthy at any size.

If you are an individual in recovery from an eating disorder, it is important to make sure that your treatment providers are not subtly reinforcing weight-bias and discrimination. There are plenty of clinicians to choose from who embrace Health at Every Size and promote body-acceptance.

2. “Inspirational” quotes and pictures that promote fat-discrimination.

There is a popular eating disorder recovery meme floating around the Internet that states, “You are not fat. You have fat. You also have fingernails but you are not fingernails.” At first glance this message appears to be comforting, however upon closer examination it serves to reinforce the thin ideal standard of female beauty.

We are so inundated with the thin-ideal standard of female beauty that fat-phobia is almost seen as a societal norm. You can be thin and be beautiful. You can be fat and be beautiful. It is important to note that all bodies are good bodies, a person’s weight does not define their worth, and having fat or being fat does not make you any less valuable as a human being.

Additionally, some of the “before and after” eating disorder recovery pictures floating around Instagram or Facebook may unintentionally promote that there is only one type of acceptable body in recovery. The reality is that body diversity exists and it is unrealistic to think that recovery for every individual means reaching a certain BMI. You can determine your natural body weight range by living your life free from weight-control and disordered behaviors and seeing what weight your body settles on.

Before sharing an inspirational recovery picture or quote, simply ask yourself whether it would apply to individuals of all body shapes and sizes. If not, you may be unintentionally promoting the thin ideal and perpetuating weight-bias.

3. Individuals who are undiagnosed or misdiagnosed due to their weight.

We’ve all heard the stories of individuals who were denied treatment by their insurance company, or misdiagnosed by doctors or treatment providers, because they were not seen as being suffering from an eating disorder-due to their weight. The reality is that a person can be suffering from an eating disorder at any size. Further, eating disorders are mental illnesses and therefore a person’s level of suffering cannot be determined on the basis of their weight. Additionally, you cannot come to any conclusions about a person’s eating habits based upon their weight.

When you judge someone’s level of suffering based upon their weight, you are serving to perpetuate the denial and shame that many individuals who have eating disorders are already struggling with. Instead, work to share the message that eating disorders do not discriminate based upon weight, social class, gender, or religion.

Unfortunately, weight-stigma surrounds us on a daily basis. However, if enough people start speaking up about weight-bias and discrimination, eventually we can work to create impactful social change. It is crucially important that we work to eliminate fat-phobia within the eating disorder recovery community and instead inspire people to learn how to embrace and love themselves-at any size

Jennifer Rollin, MSW, LGSW is a psychotherapist specializing in working with adolescents, survivors of trauma, eating disorders, body-image issues, and mood disorders. She is a blogger on The Huffington Post and Psychology Today and a freelance writer for a variety of media, including Social Work Today Magazine, Anxiety.org, and Headspace.com. “Like” Jennifer on Facebook at Jennifer Rollin, MSW, LGSW and check out her website: www.jenniferrollin.com

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About the Author

Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in Rockville, Maryland who specializes in helping teens and adults to recover from anorexia, bulimia, binge eating disorder, and body image issues.